Trends in 21st Century Epidemiology: From Scientific Discoveries to Population Health Impact

December 12-13, 2012 - Bethesda, MD

Overview

More than a decade into the 21st century, we are at a major crossroads in our understanding of cancer. Tools of molecular biology, genomics, and other high throughput "omic" technologies are increasingly integrated into epidemiologic investigations. In a 2011 town hall meeting, Dr. Harold Varmus, NCI Director, said, "I expect to see a pretty dramatic revolution in epidemiology... defining cancers by genetic subsets. I expect to see molecular tools brought more forcefully into the realm of cancer diagnosis... talking about ways to discriminate among early lesions and pre-cancerous lesions that may have malignant potential."

Along with these emerging tools come refined social, behavioral, and environmental exposure measurements at the individual, community, and health system levels and the ability to assess gene-gene and gene-environment interactions. There is an increased focus on complex "systems" approaches in understanding the occurrence of cancer and intervening at multiple levels. All this has been influenced by tremendous advances in bioinformatics and information technology, allowing us to collect, analyze, and synthesize information from multiple disciplines at an ever increasing pace.

With these opportunities, however, come the major challenge of dealing with the data deluge and uncovering true causal relationships from the millions and millions of observations that are background noise. At the same time, increased consumer awareness and education has led to enhanced participation and co-ownership of research and research output. Thus, epidemiology now confronts important challenges and opportunities in the study of cancer and other diseases, and must make choices of direction, as it responds to rapid changes in the environment.

Purpose

On December 12-13, 2012, NCI's Epidemiology and Genomics Research Program (EGRP) sponsored a workshop titled "Trends in 21st Century Epidemiology: From Scientific Discoveries to Population Health Impact" in Bethesda, MD. Researchers and thought leaders presented their perspectives on major facets of the epidemiologic enterprise.

Agenda and Presentations

During the workshop, a panel of experts with diverse perspectives offered brief assessments of the main challenges and most attractive opportunities for the five areas outlined below. Moderators led discussions among the panelists and workshop participants. Links to the presentations are included in the agenda (below) in the Topic column.

At the end of the meeting, workshop participants held an open discussion to help clarify and prioritize recommendations that will enhance the contribution of epidemiology in the next decade.

Online Participation

The meeting offered several ways for the research community to participate online. The proceedings were videocast live from http://videocast.nih.gov. The archived videocasts are available at the links below:

Online participants were invited to share their comments and questions via Twitter (by using the meeting hashtag, #trendsinepi, or @NCIEpi in their tweets) or email (nciepimatters@mail.nih.gov). Select questions from online participants were then used in the question and answer portions of the workshop sessions.

Workshop Recommendations and Summary

Eight overarching thematic recommendations, with proposed corresponding actions for consideration by funding agencies, professional societies, and the research community emerged from the collective intellectual discourse during the workshop. While the recommendations listed below are focused on cancer epidemiology, EGRP believes they apply broadly to the field of epidemiology and will serve as a strong scientific foundation to accelerate translation of scientific discoveries into individual and population health benefits. What follows are brief descriptions of all eight recommendations; a more comprehensive discussion of these recommendations and their foundations can be found in the April 2013 issue of Cancer Epidemiology, and Biomarkers and Prevention.

Recommendation #1: Extend the reach of epidemiology to include development and evaluation of clinical and population interventions, implementation, dissemination, and outcomes research.

Recommendation #2: Increase access to data, metadata, and specimens to foster collaboration, ensure reproducibility and replication, and accelerate translation to population health impact.

Recommendation #3: Expand cohort studies across the lifespan and include multiple health outcomes.

Recommendation #4: Develop, evaluate, and use novel technologies to quantify exposures and outcomes on a large scale and assess multiple factors in complex diseases.